Long-Term Care Financing
State And Local Funding
In addition to dollars that states use to match federal Medicaid expenditures (approximately 17 percent of all long-term care expenses in 1995), many states augment or create their own programs with state funds. Pennsylvania and New Jersey, for example, have relatively large home and community-based care programs supported mainly by lottery dollars. A number of local communities have also been successful in raising funds for long-term care services. Hamilton County, Ohio (the Cincinnati metropolitan area) supports services for older adults with disabilities through a county levy enacted under the leadership of the local Area Agency on Aging (AAA). In 1997, the AAA's Elderly Services Program spent 17 million dollars in levy funding for homemaker services, personal care, home-delivered meals, care management, adult day care, and transportation. This agency was able to convince both elderly and younger county residents that the levy for long-term care services was necessary, given the continuing cuts in federal funds, and that the dollars would benefit the entire community, not just older adults.